To date,clinicians and hospital systems have been independently determining how to modify their screening and lung nodule management programs during the pandemic. The consensus statement was developed to provide expert opinion to clinicians regarding the performance of lung cancer screening and the management of patients with lung nodules in a manner that is consistent with current CDC COVID-19 guidance.

Three project leaders and 21 panel members participated in developing the consensus statement. Their specialties included pulmonology, thoracic radiology and thoracic surgery. Twelve scenarios were developed, each with a statement requiring a vote. The voting results for all statements exceeded the threshold of 70% of panel members voting agree or strongly agree. Scenarios recommendations and notes are included in the report.


Consensus was unanimous for recommendations to delay baseline or repeat annual screening, and over 95% of panelists agreed to delay the evaluation of pulmonary nodules detected incidentally or by screening that have a low probability of cancer or are likely to be an indolent cancer.

Consensus was less uniform but still strong for recommendations to delay or modify the evaluation and management of patients with nodules measuring greater than 8 millimeters in average diameter.

The authors note that these recommendations are not “one-size-fits-all” and state that patient preferences should be considered in all of the scenarios, because individual patients are likely to differ in how they perceive the potential benefits and harms associated with delayed or modified evaluation and management.

The paper points out that due to the fluidity of the situation, it is not possible at this time to determine when it will be advisable to return to usual care practices.

“We hope these statements are helpful and provide some reassurance and direction to individuals who are eligible for lung cancer screening, patients with lung nodules, and the clinicians who care for them,” the authors conclude.

RSNA is committed to connecting radiologists and the radiology community to the most timely and useful COVID-19 information and resources. RSNA’s COVID-19 Resources page houses the latest guidance, original research, image collection and more. The page will be updated on an ongoing basis.

“Management of Lung Nodules and Lung Cancer Screening During the COVID-19 Pandemic: CHEST Expert Panel Report.” Peter J. Mazzone, M.D., M.P.H., FCCP, Michael K. Gould, M.D., FCCP, Douglas A. Arenberg, M.D., FCCP, Alexander C. Chen, M.D., Humberto K. Choi, M.D., FCCP, Frank C. Detterbeck, M.D. , FCCP, Farhood Farjah, M.D., M.P.H., Kwun M. Fong, M.D., Jonathan M. Iaccarino, M.D., Samuel M. Janes, Ph.D., Jeffrey P. Kanne, M.D., FCCP, Ella A. Kazerooni, M.D., Heber MacMahon, M.B.B.Ch., David P. Naidich, M.D., FCCP, Charles A. Powell, M.D., FCCP, Suhail Raoof, M.D., Master FCCP, M. Patricia, Rivera, M.D., FCCP, ATSF, Nichole T. Tanner, M.D., M.S.C.R., FCCP, Lynn K. Tanoue, M.D., FCCP, Alain Tremblay, M.D.C.M., Anil Vachani, M.D., M.S., FCCP, Charles S. White, M.D., Renda Soylemez Wiener, M.D., M.P.H., Gerard A. Silvestri, M.D., M.S., FCCP

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